Posts Tagged ‘MDR-Tuberculosis’

90-minute TB test not a game changer for India

August 30, 2011 Leave a comment


New Delhi : A new diagnostic technique that detects tuberculosis in 90 minutes instead of three months using the conventional method may not be effective in India as the heat and humidity would affect the equipment, experts said.

TB kills two people every three minutes in India, accounting for over three million (30 lakh) deaths a year.

The diagnostic technique, Gene Xpert MTB/RIF, was launched in the US in 2007 and is supported by the World Health Organisation. It was launched in India last year.

However, a health ministry official said the technique may not be a game changer in India due to the staggering burden of tuberculosis the country is currently facing.

The technique enables rapid diagnosis of tuberculosis, multi-drug resistant TB (MDR-TB) and TB in HIV-infected individuals in a span of 90 minutes compared to the conventional test.

“The technique cannot be used for routine testing. We have pilot projects at 18 sites going on to test its feasibility in the Indian situation where the climate and temperature conditions are different from the western countries,” said Ashok Kumar, deputy director general of the central TB control division under the ministry of health and family welfare, at a conference by Stop TB partnership.

When the technique was launched September 2010, health experts pinned their hopes on the test promising a quicker diagnosis of Multi-Drug Resistant TB by looking for bacterial DNA in a person’s sputum.

“The pilot projects are in consultation with the WHO. The idea is to take the test near to the districts and remote areas where the conditions under which TB originates could be different,” Kumar explained.

According to experts, high humidity and high temperature may affect the equipment and cartridges used in the test. Invariable temperature can also lead to inconsistency in the results.

“Solid culture/sputum testing remains the golden standard for Indian conditions. Xpert test can be used for HIV positive patients, but not in routine testing,” Kumar said.

According to officials from the TB control division in the health ministry, the cost would be incurred by the ministry. The test costs around Rs.900 ($20) per sputum sample.

Blessi Kumar, a TB prevention activist and vice chairperson of Stop TB partnership coordinating board, said thought should be given to the technique to make it effective.

“The Indian research community and pharma industry should take on the task of going deeper into the 90-minute test. It can be a scientific advancement or a stepping stone that India needs to reduce TB cases,” Kumar said.


TB battle: States told to follow WHO guidelines

The Union Health Ministry has asked all state tuberculosis (TB) officers to endorse the recommendations of the World Health Organization (WHO), urging countries to ban “unapproved” blood tests to diagnose the disease.

In a letter to the officers, consultants and senior regional directors, the Deputy Director General, head, Central TB Division, Dr Ashok Kumar, has asked them to “disseminate this message to all stakeholders involved in TB control in India”. According to the WHO, the use of currently available commercial blood (serological) tests to diagnose active TB often leads to misdiagnosis, mistreatment and potential harm to public health.

The WHO has, therefore, urged countries to ban the inaccurate and unapproved blood tests and instead rely on accurate “microbiological or molecular tests”.

The new recommendation comes after 12 months of rigorous analysis of evidence by WHO and global experts. “Overwhelming evidence showed that the blood tests produced an unacceptable level of wrong results — false-positives or false-negatives,” it said.

According to Dr Kumar, the serological tests continue to be used extensively specially in the private health sector.

Source:- The Indian Express

Manipur first in Northeast-India region to test multi drug-resistant tuberculosis

Imphal: Manipur will have the first centre in the Northeast to treat multi drug-resistant TB, with one of the four national reference centres assuring the state’s intermediate reference laboratory of accreditation, in order to function as a national reference laboratory.

A team from Delhi’s Lala Ram Swarup Hospital, one of the four national reference laboratories of the country for testing multi drug-resistant TB, visited the state’s intermediate reference laboratory at the medical department’s research and development wing at Lamphelpat of Imphal West last month.

“The team was satisfied with our laboratory and work. They assured us that accreditation would be given to our laboratory as a national reference laboratory within three months,” state TB officer Ak. Khamba said.

The intermediate reference laboratory was opened on March 19 this year for Manipur, Nagaland and Mizoram. The Centre also sanctioned an intermediate reference laboratory for Assam, Arunachal Pradesh and Sikkim. Only the Imphal laboratory is functioning so far.

The officer said so far, 16 blood samples from Imphal and Imphal East were tested for multi drug-resistant TB at the laboratory. Of them, nine tested positive.

The samples of the positive cases will be sent to Lala Ram Swarup Hospital and the Delhi national reference laboratory would declare the final results.

Once the Imphal centre gets the accreditation, it can declare the results of the positive cases and start treating the patients immediately.

“We have requested the health departments of Mizoram and Nagaland to send samples for testing at the Imphal laboratory. They will be sending the samples very soon,” the officer said.

Khamba said till the Imphal laboratory opened, the authorities did not know of the existence of multi drug-resistant TB cases in the state.

“Many TB patients died and we are now suspecting that they were died of the multi drug-resistant TB. Samples from other districts of Manipur will also start coming to the Imphal laboratory for testing,” he said.

He said because of high HIV/AIDS prevalence, the number of TB cases was high in the state.

The state government identified two rooms at the state-run Jawaharlal Nehru Institute of Medical Sciences here to develop it as a ward for patients with multi drug-resistant TB.

The ward will have 10 beds — five each for men and women. The duration of treatment is 28 months. The ward will start functioning by August this year.

“The detection of the nine cases is only the tip of the iceberg. We have reasons to believe that there are many cases of multi drug-resistance TB patients in Manipur as TB patients did not take medicines properly during the first line of treatment,” he said.

If a TB patient undergoes the first line of treatment properly, he would be cured and would not contact multi drug-resistant strain, experts said.

Dr K. Priyokumar, the nodal officer of the ART Centre of the Jawaharlal Nehru Hospital here, said TB was not a killer disease even if an HIV-infected person contracted it as secondary infection. “But it becomes a killer disease when the patient fails to follow the doctors’ advice or take the full course of the prescriptions and starts spreading drug-resistant TB to others. It is because of this reason that number of patients is increasing not only in Manipur but also in India,” the doctor said.

He said HIV-positive patients were vulnerable to TB because their immune system was very low. He said about 30 to 35 per cent of the HIV/AIDS patients coming for treatment to the hospital were infected by TB.